Consolidation After HD-MTX Rechallenge in Late-Relapsed Primary CNS Lymphoma
Clinical scenario
This protocol applies to patients with primary CNS lymphoma who develop a late relapse after achieving long-lasting remission on an initial HD-MTX-based combination regimen — a distinct presentation that guides treatment sequencing.
Prior treatment step
Patients in this setting are re-treated with HD-MTX rechallenge, employing the same or a similar chemotherapy regimen as used in first-line treatment. The goal of that step is achievement of response — complete remission or partial response — on brain MRI. This consolidation protocol is the designated next step for patients who achieve that response.
Consolidation (partial overview)
For patients who achieve response on rechallenge, consolidation with an intensified modality is recommended. The full protocol specifies which approaches are indicated and under what conditions each applies — access the complete structured regimen below.
References
- DOI: 10.1016/j.annonc.2023.11.010
- Patients with late relapse of PCNSL could be re-treated with HD-MTX, employing the same or similar ChT regimen used in first-line treatment, and consolidated with ASCT or WBRT in the case of response.
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